Tag Archives: corneal refractive therapy

Bifocal Lenses in Nearsighted Kids (BLINK) Study Begins

The National Institutes of Health awarded the University of Houston College of Optometry and the Ohio State University College of Optometry $7.5 million to study the use of soft bifocal contact lenses in the prevention of nearsightedness (myopia) in children. The Bifocal Lenses in Nearsighted Kids (BLINK) Study will follow 300 children, ages 7 to 11 years of age over a period of 3 years. The Ohio State University College of Optometry previously published the Corneal Reshaping and Myopia Study in a 2009 issue of the British Journal of Ophthalmology where it found that orthokeratology lenses were effective in preventing the lengthening of the eyeball in children which in turn slowed the progression of nearsightedness.

Myopia Regulation Treatment at Total Eye Care

Do you have a family history of nearsightedness? Are your kids nearsighted? Would you like to prevent the progression of myopia in your kids? Summer is a great time start Myopia Regulation Treatment. If you would like more details you can set up a free consult with Dr. Driscoll.

More information about orthokeratology can be found at the OrthoKDoctor.com website.

The study of myopia control (nearsightedness) is a hot field of study, particularly in China where the High Myopia – Partial Reduction Orthokeratology (HM-PRO) study was conducted. This study is the latest in an effort to find an effective means to slow or even stop the progression of nearsightedness in children. The HM-PRO study is unique in that it treated 18 highly myopic children (Rx over -5.75 D) between the ages of 8 and 11 with a combination of OrthoK lenses and glasses, and followed them for two years. The study participants were matched with a control group of 18 children, the same age and also with prescriptions over -5.75D.

In the HM-PRO study 18 participants and 18 control patients were followed for 2 years. 15 of the treatment patients and 13 control patients completed the study. After two years the treated patient’s nearsightedness increased by – 0.13D and the untreated (control) patients increased their nearsightedness by -1.00D.

Myopic progression is also measured by how much the eye grows in length (called the axial length). In this case the treated patients showed a significant reduction in progression with their axial length increasing by 0.19 mm whereas the control group’s axial length increased by 0.51 mm.

The study authors concluded that orthokeratology lenses slowed axial length elongation by 63% and reduced the prescription change by 87%. It has yet to be shown that orthokeratology lenses stop the myopic progression clearly this study, like numerous other before it, show that orthokeratology is effective in markedly slowing the progression of nearsightedness in children. At Total Eye Care we have been using reverse curve orthokeratology lenses to control myopia since 1999 and have fit hundreds of kids and adults.

The rate of nearsightedness in the US has increased by over 66% in the past 30 years says a study published in the December 2009 issue of Archives of Ophthalmology

A 66% increase in myopia is a huge change over a 30 year period. The new study tried to simulate the testing methods of the original 1972 study on nearsightedness in the US population. The 1971-1972 National Health and Nutrition Examination Survey found that 25% of the US population between the ages of 12 and 54 were nearsighted vs the 1994-2004 National Health and Nutrition Examination Survey’s finding of 41.6%. Increased nearsightedness was noted regardless of age, sex, race or education.

The authors concluded that it would be beneficial to identify behavioral risk factors that cause increased myopia. If risk factors for increasing myopia are identified we may be able to slow the progression.

The big question is “what caused this increased nearsightedness in the US population”? As eye doctors we are often asked what causes nearsightedness and the usual answer is that that we believe nearsightedness is a combination of genetics and environmental influences. In the last 30 years our society has become much more near centric. People spend hours glued to their computer monitors at work and home. Kids spend more time at near now then ever before with computer games, hand held games etc.

Numerous recent studies have shown that orthokeratology contact lenses can greatly slow the progression of nearsightedness

Finding ways to slow or halt the progression of myopia has been a longstanding subject of study in eyecare. The process of using special contact lenses to reshape the front part of a patient’s eye to prevent the progression of nearsightedness and to allow the patient to see without glasses is called orthokeratology. There are a number of different names for orthokeratology, orthoK, corneal molding, corneal reshaping and corneal refractive therapy are some of the most common names.

Almost a year ago the study, Controlling Astigmatism & Nearsightedness in Developing Youth (CANDY) showed that orthokeratology contact lenses reduced the progression of nearsightedness in kids between 9 and 16. The authors of the CANDY study found that the amount myopia in children that did not wear the overnight Corneal Refractive Therapy lenses increased at a rate of .37D per year while those children wearing the lenses progressed at only .03 diopters per year.

Another study, Corneal Reshaping and Myopia Progression published in the British Journal of Ophthalmology, conducted at the Ohio State University College of Optometry found that the eyes of the children wearing overnight orthokeratology lenses increased in length at a markedly slower rate than the studies’ non ortho-K lens wearers.

The first year of the Stabilization of Myopia by Accelerated Reshaping Technique (SMART) Study has produced some encouraging results in a recent announcement. According to Dr. Robert L. Davis, co principal investigator of the SMART trial, “The net effect of this contact lens fitting philosophy is to change the cornea shape for the sole purpose of reducing the amount of myopia as measured by change in refraction” . “The results of the SMART Study so far are very exciting,” said Dr. Davis. “The outcomes of this study may revolutionize how we manage young nearsighted patients from this point forward”.

The SMART Trial involves 300 patients between the ages of 8 and 14. The goal of the study is to see if having patients where overnight orthokeratology or corneal molding lenses will stop or slow the progression of nearsightedness. The SMART Trial is the largest of its kind. Other studies have also shown that preventing nearsightedness with ortho-K contact lenses is possible, such the CANDY Study. A study from Ohio State Unversity suggested that wearing Ortho-K lenses overnight actually prevented the eye from becoming longer. The SMART Trial has just completed the first year of the five year study. We will continue to keep an eye on this potientially ground breaking study.

Study from Ohio State University Confirms Prior Studies Myopia Slowed With Contacts

In February, here in The Eye Doc Blog, we reported that The CANDY Study showed that OrthoKeratology contact lenses markedly slowed the progression of nearsightedness in children. The results of The CANDY study have now been confirmed in the British Journal of Ophthalmology, the new study, Corneal Reshaping and Myopia Progression, showed that children wearing corneal reshaping lenses, also known as ortho-K or orthokeratology lenses significantly reduced the rate of change of the length of the children’s eyes. The study participants wore the lenses for two years and ranged in refractive error from -0.75 to -4.00. The study concluded that previous reports of slowed eye growth following corneal refractive therapy were confirmed.

It’s good to see another study indicating that Orthokeratology Contact Lenses prevent the progression of nearsightedness (myopia). The Controlling Astigmatism & Nearsightedness in Developing Youth Study (CANDY) was based on a relatively small population (28 patients) and it would have been good to see the rate of myopic progression after removing the contact lenses over a greater period of time, however the data was compelling and warrants further study.

As eye doctors we are often asked if we can prevent the progression of nearsightedness in children. Clinically, we feel that the answer is probably yes, however there are relatively few studies that have investigated this common question. The CANDY Study backs up what we feel our clinical experience has taught us. The progression of nearsightedness in CANDY study patients was 0.37D prior to wearing overnight Ortho-K contact lenses. When the patients discontinued wearing their lenses they found that the patient’s refractive error, on average, had increased by only 0.03D.

An FDA sponsored study of 300 children started in 2007 and is expected to continue for 5 years. Hopefully, the FDA study will answer more of our questions. Additional findings from the CANDY Study found that the younger the child the more beneficial was the effect on controlling myopia and the technique was more convenient. A more comprehensive look at Orthokeratology including a link to the CANDY Study is available on the Total Eye Care website.